Developing an Acute Frailty Audit

Following on from the publication of the National Institute for Health Research (NIHR) Dissemination Centre ‘Comprehensive Care: Older people living with frailty’ themed review in 2017, the Wessex Acute Frailty Audit looks at the standard of care that is provided for a person living with frailty in our local acute hospitals.

The project was run by the Wessex Academic Health Science Network (AHSN) in collaboration with 8 acute trusts (covering 9 hospital sites) and a community hospital (which has some acute beds) to gain a regional understanding of care provision. The audit aimed to identify areas of good practice and also significant gaps in frailty identification, personalised assessment and care planning, and hospital wide provision of frailty training with an overall aim to regionally drive up standards of care and improve patient outcomes.

The audit and subsequent workshop identified gaps in frailty service provision and opportunities for service improvement across Wessex. Two working groups have been convened by the Wessex AHSN Healthy Ageing programme as a result of the audit outcomes. 

Planned outputs from clinically led working groups include:

• Development of Frailty awareness and training tools to support Tier 1 and Tier 2 Skills for Health Frailty Competency Framework to be accessible to acute, community, and GP colleagues to support the concept of frailty awareness from “Board to Porter”. It is also proposed to provide access to the material to patients, carers and family members
• Development of a Wessex AHSN Gold Standard for frailty screening, capture of frailty identification, and the sharing of information with all clinical stakeholders (hints and tips)
• Development local case studies showcasing delivery of best practice for frailty screening, identification and sharing of information

The development and completion of the audit has also enabled the following opportunities:

• Sharing of knowledge and experience of the audit journey with other AHSNs and clinicians
• Consideration of sharing the audit tool with other interested AHSN sites, with a view that Wessex AHSN will seek consent to host the tool to enable national analysis
• Provided a vehicle to promote the outputs of the service improvement projects to promote best practice and spread new initiatives both locally and nationally
• Provision of a platform to influence the national agenda with national frailty leads
• Showcased the collaborative working with Wessex AHSN and NHS Benchmarking to showcase and champion the audit work
• Promotion of the frailty agenda in specialities outside of Medicine for Older People, “The frailty audit we did with the surgical team helped to make contacts and raise awareness” [Trust feedback]

The Healthy Ageing Programme plan to re-audit acute trusts in 2021 which will enable measurement of improvement from the baseline audit in 2018. Please visit https://wessexahsn.org.uk/projects/346/wessex-acute-frailty-audit-autumn-2021 for more details.